Flashcards in Renal Random Facts Deck (87)
What does the mesonephros become?
Men- Wolffian ducts (ductus deferens and epidydimus); Women- vestigal Gartner's duct
What is a multi cystic dysplastic kidney
Due to abnormal interaction between ureteric bud and metanephric mesenchyme. Leads to a nonfunctional kidney consisting of cysts and connective tissue
Relationship to ureter to ductus deferens
Ureters pass under the ductus deferens
What do the uterine vessels travel in?
What is the 60-40-20 rule?
60% total body water: 40% intracellular, 20% ECF
How do you measure plasma volume and extracellular volume?
Plasma volume measured by radio labeled albumin, extracellular volume measured by inulin
Equation for renal blood flow
RBF=RPF/(1-Hct); RPF is the clearance of PAH
How does changing the plasma protein concentration change the GFR, RPF, and FF?
Increased plasma protein concentration decreases the GFR, doesn't affect the RPF, and therefore decreases the FF (GFR/RPF)
Autosomal recessive, deficiency of neutral amino acid transporters in proximal renal tubular cells and on enterocytes, causes a neutral aminoaciduria and decreased absorption from the gut
What is Fanconi syndrome
Generalized reabsorptive defect in PCT, associated with increased excretion of nearly all amino acids, glucose, HCO3-, and PO4(3-). May result in metabolic acidosis (proximal renal tubular acidosis)
AR, affects Na/K/2Cl transporter, results in hypokalemia and metabolic alkalosis with hypercalciuria
AR, reabsorptive defect of NaCl in DCT. Leads to hypokalemia, hypomagnesemia, metabolic alkalosis, hypocalciuria
AD, Gain of function mutation causing increased Na reabsorption in collecting tubules (increased activity of epithelial Na channel). Results in hypertension, hypokalemia, metabolic alkalosis, decreased aldosterone. Tx: amiloride
Syndrome of apparent mineralocorticoid excess
Hereditary deficiency of 11-beta-hydroxysteroid dehydrogenase, which normally converts cortisol into cortisone in mineralocorticoid receptor containing cells before cortisol can act on the mineralocorticoid receptors. Causes hypertension, hypokalemia, metabolic alkalosis. Low serum aldosterone levels.
Actions of angiotensin II (6)
1. acts at ATII receptors on vascular SM to cause vasoconstriction, 2. Constricts effect arteriole of glomerulus, 3. Increases aldosterone, 4. Stimulates ADH leading to H2O reabsorption, 5. Increases PCT Na/H activity, 6. Stimulates the hypothalamus (thirst)
How does the macula densa work?
Senses decreased NaCl deliver to DCT causes adenosine release, causes vasoconstriction
Where does Epo come from?
Interstitial cells in peritubular capillary bed
Where is vitamin D converted to its active form?
By the PCT cells
What do ADH and aldosterone regulate?
ADH regulates osmolarity, aldosterone regulares ECF volume and Na content
Effect of ANP
Causes increased GFR and increased Na filtration with NO compensatory Na reabsorption in distal nephron. Net effect: Na loss and volume loss
What causes K to shift out of cells?
Digitalis, hyperosmolarity, lysis of cells, acidosis, beta-blocker, high blood sugar (insulin deficiency) [DO LABS}
How do you monitor for too much magnesium?
DTRS (hypermagnesemia decreases DTRs), also causes lethargy, bradycardia, hypotension, cardiac arrest, and hypocalcemia
Respiratory compensation for metabolic acidosis
Winters formula. Pco2= 1.5[HCO3-] +8 +/-2
What can cause a metabolic alkalosis?
Loop/thiazide diuretics, vomiting, antacid use, hyperaldosteronism
What causes an anion gap metabolic acidosis?
MUDPILES: methanol, uremia, diabetic ketoacidosis, propylene glycol, iron tablets/isoniazid, lactic acidosis, ethylene glycol (oxalic acid), salicylates
What causes a normal anion gap metabolic acidosis?
HARD-ASS: hyperalimentation, addison disease, renal tubular acidosis, diarrhea, acetazolamide, spironolactone, saline infusion
Type 1 renal tubular acidosis
Distal, urine pH >5.5, defect in ability of alpha-intercalated cells to secrete H+ -> no new HCO3- is generated -> metabolic acidosis. Associated with hypokalemia, increased risk for calcium phosphate kidney stones (due to increased urine pH and increased bone turnover)
Type 2 RTA
Proximal, urine pH
Causes of type 2 RTA
Fanconi syndrome and carbonic anhydrase inhibitors